Journal of Orthopaedic Science最新文献

{"title":"Validation of Hounsfield units for preoperative bone mineral density assessment in intertrochanteric femoral fractures","authors":"Shuichi Eto,&nbsp;Shunji Imanishi,&nbsp;Wataru Komuta,&nbsp;Yosuke Oba,&nbsp;Nobumichi Hidaka","doi":"10.1016/j.jos.2025.08.005","DOIUrl":"10.1016/j.jos.2025.08.005","url":null,"abstract":"<div><h3>Background</h3><div>Hounsfield units (HU) on computed tomography (CT) are strongly correlated with bone mineral density (BMD) and may aid in osteoporosis screening. However, there is no standardized method for assessing bone density in displaced femoral head fractures. This study aimed to measure HU values in the femoral head using preoperative post-fracture CT images of patients with intertrochanteric femoral fractures and investigate whether it correlated with BMD measured by dual-energy X-ray absorptiometry (DXA).</div></div><div><h3>Materials and methods</h3><div>We retrospectively analyzed post-fracture CT images of intertrochanteric fractures (n = 52). Hounsfield units were measured in the axial, coronal, and sagittal planes using the femoral neck axis as a reference. Severe osteoporosis was defined as &lt;60 % of the young adult mean (YAM) (T-score &lt;−3.3). We evaluated the correlations between HU and DXA-derived BMD, along with reliability (intraclass correlation coefficient [ICC]), measurement bias (Bland–Altman analysis), and diagnostic performance (receiver operating characteristic [ROC]).</div></div><div><h3>Results</h3><div>HU values demonstrated strong associations with BMD across all planes, with the highest correlations observed in the axial and coronal planes. ICC values exceeded 0.9, indicating excellent reliability. Bland–Altman analysis revealed no proportional bias but a fixed bias in the sagittal plane, whereas the narrowest limits of agreement were observed in the axial plane. Based on the ROC analysis, an axial HU cutoff of 151.5 identified severe osteoporosis (sensitivity, 0.756; specificity, 0.783).</div></div><div><h3>Conclusions</h3><div>Axial HU measurements were most reliable for assessing the bone quality. This cutoff value may help identify severe osteoporosis and determine eligibility for cement augmentation. However, further validation is needed.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 444-449"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of Birmingham hip resurfacing: Minimum 2-year follow-up clinical outcomes in obese vs. non-obese populations","authors":"Roger Quesada-Jimenez ,&nbsp;Elizabeth G. Walsh ,&nbsp;Ady H. Kahana-Rojkind ,&nbsp;Benjamin D. Kuhns ,&nbsp;Andrew R. Schab ,&nbsp;Benjamin G. Domb","doi":"10.1016/j.jos.2025.07.012","DOIUrl":"10.1016/j.jos.2025.07.012","url":null,"abstract":"<div><h3>Background and objective</h3><div>With obese individuals experiencing osteoarthritis (OA) at early stages of life, hip resurfacing (HR) has emerged as an alternative to arthroplasty. The purpose is to conduct a short-term analysis on patients with obesity who underwent primary HR for OA compared to a benchmark control group of non-obese patients.</div></div><div><h3>Materials and methods</h3><div>Patients with a body mass index (BMI) ≥ 30 kg/m2 who underwent HR from 2010 to 2021 were eligible for inclusion. Included patients had pre-operative and minimum 2-year follow-up for the Modified Harris Hip Score (mHHS), Hip Disability and Osteoarthritis Outcome Score Joint Replacement Score (HOOS-JR), Forgotten Joint Score (FJS), Visual Analog Scale for Pain (VAS), and patient satisfaction or reached an endpoint revision surgery during the study time frame. Patients were propensity matched in a 1:1 ratio based on approach, age, and follow-up time. Clinically relevant outcome thresholds, sports participation, acetabular cup placement, complications, and conversions to total hip arthroplasty (THA) were included in the analysis.</div></div><div><h3>Results</h3><div>Seventy patients were included. Obese patients displayed significant improvements across all patient reported outcomes (PROs) and high patient satisfaction at short-term follow-up that was comparable to the non-obese group. Both groups also showed a similar return to sport and acetabular cup placement and met clinically relevant thresholds at similar rates. The obese group, specifically patients with a BMI&gt;35, exhibited higher complication and revision surgery rate.</div></div><div><h3>Conclusions</h3><div>HR in patients with obesity showed significant short-term improvements, allowing a high percentage of patients to return to sports. These results were equivalent to a benchmark control group of non-obese patients. Additionally, obese patients tended to have an increased risk of complications than non-obese patients, with a higher rate of conversion to THA.</div><div><strong>Level of Evidence</strong>Level of Evidence III.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 364-371"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and prognosis of malignant peripheral nerve sheath tumor (MPNST) in Japan: A population-based analysis using the national cancer registry","authors":"Shudai Muramatsu ,&nbsp;Koichi Ogura ,&nbsp;Chigusa Morizane ,&nbsp;Tomoyuki Satake ,&nbsp;Shintaro Iwata ,&nbsp;Eisuke Kobayashi ,&nbsp;Takahiro Higashi ,&nbsp;Yu Toda ,&nbsp;Toshiyuki Takemori ,&nbsp;Hiroya Kondo ,&nbsp;Akira Kawai","doi":"10.1016/j.jos.2025.09.007","DOIUrl":"10.1016/j.jos.2025.09.007","url":null,"abstract":"<div><h3>Background</h3><div>The national epidemiology of malignant peripheral nerve sheath tumor (MPNST) remains underexplored. We analyzed Japanese domestic statistics for MPNST using the National Cancer Registry (NCR), a population-based database launched in 2016.</div></div><div><h3>Methods</h3><div>We analyzed 837 MPNST cases diagnosed between 2016 and 2019, comparing them with 22,685 non-MPNST soft tissue sarcomas. We assessed demographics, treatment, and survival using Kaplan-Meier and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>The age-adjusted incidence of MPNST in Japan was 0.13 per 100,000. Unlike other sarcomas, MPNST showed a balanced sex ratio and a relatively higher proportion of adolescent and young adult (AYA) patients (18.5 % vs. 10.7 %, p &lt; 0.001). Most MPNSTs (87.4 %) originated from the skin and soft tissues. The 3-year survival rate for MPNST patients (53.0 %) was lower than that for other sarcomas (64.3 %, p &lt; 0.001). Surgery was associated with longer survival (hazard ratio [HR]: 2.09; p &lt; 0.001), while no clear benefit was observed for chemotherapy or radiotherapy. Radiotherapy was more frequently used in MPNST patients (21.1 % vs. 15.6 %, p &lt; 0.001), likely reflecting a selection bias towards non-surgical cases.</div></div><div><h3>Conclusions</h3><div>This is the first study to analyze the national epidemiology and prognosis of MPNST in a socio-economically homogeneous, single ethnic group. MPNST primarily affected the skin and soft tissues, with a higher incidence in the AYA group. Surgery was associated with better outcomes, whereas chemotherapy and radiotherapy implied poorer prognosis owing to selection bias for unresectable cases. The NCR provides a valuable model for research on rare diseases in homogeneous populations.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 473-479"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized controlled trial comparing the outcomes of the modified Stoppa and ilioinguinal approaches in the surgical treatment of acetabular fractures","authors":"Ajay Sharma ,&nbsp;Laxman Choudhary ,&nbsp;Akshant Chandel ,&nbsp;Satyendra Kumar ,&nbsp;Amandeep Bains","doi":"10.1016/j.jos.2025.08.006","DOIUrl":"10.1016/j.jos.2025.08.006","url":null,"abstract":"<div><h3>Background</h3><div>The Stoppa approach was modified to manage fractures of the anterior column as an alternative to the ilioinguinal approach to reduce complications. A debate persists regarding the superiority of one approach over the other. Therefore, in the present study we performed a randomized controlled trial (RCT) to investigate the following hypotheses: (1) Whether the modified Stoppa approach leads to reduced blood loss, (2) Whether the functional and radiological outcomes with the modified Stoppa approach are superior to those with the ilioinguinal approach, and (3) Whether the complication rates differ between the two approaches.</div></div><div><h3>Methods</h3><div>A total of 92 patients were initially enrolled in the study. After applying exclusion criteria and obtaining informed consent, 60 patients with acetabular fractures were randomly allocated into two groups and underwent internal fixation at our tertiary care hospital using either the ilioinguinal approach or the modified Stoppa approach. Bleeding and surgical time was evaluated intraoperatively. Post-operative evaluation of wound drainage and neurovascular status was done. Post-operative radiographs reduction assessment of reduction was done as per Matta scoring and clinically Merle D'Aubigne score was compared at 12 months. All data were statistically analyzed with non-parametric tests by using SPSS 20.0 software.</div></div><div><h3>Results</h3><div>Among the studied population, 48.3 % cases (21.6 % and 26.7 % with ilioinguinal and modified Stoppa approach, respectively) of all patients exhibited excellent radiological outcomes. Additionally, 33.3 % (15 % with the ilioinguinal approach and 18.3 % with the modified Stoppa approach) achieved an excellent clinical score based on the Merle D'Aubigne criteria at 12 months. However, no significant difference was found between two approaches. Both the approaches offer adequate exposure however; quadrilateral surface is directly visualised with the modified Stoppa approach. Considering two significant findings, i.e., reduced intra-operative blood loss and shorter surgical duration was associated with the modified Stoppa approach.</div></div><div><h3>Conclusion</h3><div>Notably, in the context of the ongoing debate between proponents of these two approaches, our study presents a valuable contribution. Overall, the modified Stoppa approach is a better choice in treating anterior acetabular fractures.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 438-443"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is preoperative albumin level associated with wound complications after oncologic surgery for spinal metastases? An ACS-NSQIP analysis","authors":"Ali Haider Bangash ,&nbsp;Victoria Cao ,&nbsp;Rose Fluss ,&nbsp;Sertac Kirnaz ,&nbsp;Saikiran G. Murthy ,&nbsp;Yaroslav Gelfand ,&nbsp;Reza Yassari ,&nbsp;Rafael De la Garza Ramos","doi":"10.1016/j.jos.2025.08.010","DOIUrl":"10.1016/j.jos.2025.08.010","url":null,"abstract":"<div><h3>Background</h3><div>Wound complications following metastatic spine tumor surgery (MSTS) can significantly impact patient recovery and delay adjuvant therapy. While nutritional status has been implicated in surgical outcomes, the specific relationship between preoperative albumin levels and wound complications after MSTS remains incompletely understood. We investigated the association between preoperative albumin levels and wound complications following MSTS.</div></div><div><h3>Methods</h3><div>We analyzed the data of 2195 patients who underwent MSTS from the American College of Surgeons National Surgical Quality Improvement Program database (2018–2023). The primary endpoint was a composite of wound complications (dehiscence, superficial/deep incisional infections, organ/space surgical site infections) within 30 days. The secondary endpoint was reoperation due to wound complications. Univariable and multivariable logistic regression analyses assessed associations between patient/operative characteristics and outcomes, with albumin level evaluated both: continuously and categorically.</div></div><div><h3>Results</h3><div>Wound complications occurred in 4 % (88/2195) of patients, with 22 % (19/88) requiring reoperation. Complications were observed in 3 % of normoalbuminemic patients, 5 % with mild hypoalbuminemia, and 8 % with severe hypoalbuminemia. Multivariable analysis controlling for chronic steroid use, operative time, perioperative transfusion, and posterior instrumentation revealed that each 1 g/dL increase in preoperative albumin was independently associated with 31 % lower odds of wound complications (OR 0.68 [95 % CI 0.49–0.95]; p = 0.026). Severe hypoalbuminemia (&lt;2.5 g/dL) more than doubled complication risk compared to normal levels (OR 2.15 [95 % CI 1.01–4.56]; p = 0.045). Preoperative albumin level was not significantly associated with reoperation due to wound complications.</div></div><div><h3>Conclusions</h3><div>These findings suggest the potential value of albumin as a modifiable risk factor in preoperative assessment for candidates of MSTS. Future prospective studies should validate these findings and investigate whether nutritional optimization targeting albumin levels can reduce complications in this vulnerable patient population.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 305-312"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for osteoarthrosis in the second and third tarsometatarsal joints in patients with hallux valgus","authors":"Saori Ishibashi ,&nbsp;Tomoyuki Nakasa ,&nbsp;Yasunari Ikuta ,&nbsp;Shingo Kawabata ,&nbsp;Satoru Sakurai ,&nbsp;Dan Moriwaki ,&nbsp;Nobuo Adachi","doi":"10.1016/j.jos.2025.09.006","DOIUrl":"10.1016/j.jos.2025.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Hallux valgus (HV) is prevalent in older adults and often coexists with osteoarthrosis (OA) of the second and third tarsometatarsal (TMT) joints, leading to functional impairment. Because OA changes in these joints are irreversible, understanding factors influencing OA is critical for improving therapeutic strategies. This study aimed to identify the factors influencing second and third TMT OA development.</div></div><div><h3>Methods</h3><div>This retrospective study included 108 feet with HV. Patients were divided into the OA group (33 feet) and the non-OA group (75 feet) according to the complaint of their pain in the dorsum of the foot. Clinical data and radiographic parameters such as the HV angle (HVA), intermetatarsal angle (IMA) and M1M5 angles, Meary angle, calcaneal pitch angle, and first TMT angle, and metatarsal length were analyzed. Logistic regression was used to identify factors associated with OA in the second and third TMT joints.</div></div><div><h3>Results</h3><div>In the OA group, age, body mass index (BMI), HVA, IMA, M1M5, 1st TMT, Meary, and CP angles were significantly higher, and the M3/M1 and M4/M1 ratios were significantly lower than those in the non-OA group. Logistic regression identified body mass index (BMI) (p &lt; 0.01), age (p &lt; 0.05), Meary angle (p &lt; 0.01), and M4/M1 ratio (p &lt; 0.05) as significant predictors of OA.</div></div><div><h3>Conclusion</h3><div>Degeneration of the second and third TMT joints was associated with the severity of HV and correlated with structural deformities such as reduced medial longitudinal arches. Identifying key factors such as BMI and radiographic parameters can provide insights into the pathogenesis of HV-related TMT-OA and provide targeted therapeutic interventions.</div></div><div><h3>Level of evidence</h3><div>4.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 401-405"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between hallux valgus pain and foot-related quality of life: The hallux valgus and pain epidemiology study","authors":"Yasutaka Murahashi ,&nbsp;Masatake Matsuoka ,&nbsp;Seiji Kimura ,&nbsp;Atsushi Teramoto ,&nbsp;Tomohiro Onodera ,&nbsp;Akinobu Nishimura ,&nbsp;Hideaki Nagamoto ,&nbsp;Yuka Kimura ,&nbsp;Ken Innami ,&nbsp;Ryosuke Nakagawa ,&nbsp;Takumi Matsumoto ,&nbsp;Kentaro Amaha ,&nbsp;Kenichiro Takeshima ,&nbsp;Hiroyuki Seki ,&nbsp;Masafumi Horie ,&nbsp;Ryo Matsunaga ,&nbsp;Hirokazu Okada ,&nbsp;Kenjiro Wakabayashi ,&nbsp;Masanori Taki ,&nbsp;Kuniji Ohara ,&nbsp;Satoshi Yamaguchi","doi":"10.1016/j.jos.2025.09.005","DOIUrl":"10.1016/j.jos.2025.09.005","url":null,"abstract":"<div><h3>Background</h3><div>The etiology and treatment outcomes of hallux valgus (HV) are widely investigated. However, research on pain and its impact on quality of life (QOL) remains limited. This study aimed to examine the detailed characteristics of pain associated with HV and to assess how this pain impacts daily activities and QOL.</div></div><div><h3>Methods</h3><div>We conducted a large cross-sectional investigation, the Hallux Valgus and Pain Epidemiology Study, in Japan. A total of 1700 participants, aged ≥20 years, provided foot photographs and completed a self-administered questionnaire. The <u>HV</u> angle was measured using the submitted photographs. Propensity score matching for age and sex was performed to compare QOL outcomes, using the Self-Administered Foot Evaluation Questionnaire (SAFE-Q), between participants with and those without HV.</div></div><div><h3>Results</h3><div>Among the 1700 participants, 419 were diagnosed with HV. Those with HV exhibited lower QOL scores across all self-administered foot evaluation questionnaire subscales, including pain, physical functioning, social functioning, and footwear. Greater HV severity correlated with increased foot pain (33.6 % in mild and 57.1 % in severe cases) and reduced QOL. Pain was most common in the big toe in mild/moderate cases but shifted to the lesser toes and metatarsal regions in severe cases. Multivariate analysis revealed the <u>HV</u> angle, daily physical activity, and coexisting knee pain as significant factors associated with HV pain.</div></div><div><h3>Conclusions</h3><div>HV severity is closely associated with pain and lower QOL, particularly in cases involving pain in the lesser toes and metatarsalgia. Identifying risk factors for HV pain can guide preventive measures and improve patient outcomes.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 392-400"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status and challenges of the Japanese orthopaedic association","authors":"Hirotaka Kawano","doi":"10.1016/j.jos.2026.01.001","DOIUrl":"10.1016/j.jos.2026.01.001","url":null,"abstract":"","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 273-274"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and risk factors of hallux valgus in Japanese population: HAPPI study","authors":"Masatake Matsuoka ,&nbsp;Yasutaka Murahashi ,&nbsp;Seiji Kimura ,&nbsp;Tomohiro Onodera ,&nbsp;Atsushi Teramoto ,&nbsp;Akinobu Nishimura ,&nbsp;Hideaki Nagamoto ,&nbsp;Yuka Kimura ,&nbsp;Ken Innami ,&nbsp;Ryosuke Nakagawa ,&nbsp;Takumi Matsumoto ,&nbsp;Kentaro Amaha ,&nbsp;Kenichiro Takeshima ,&nbsp;Hiroyuki Seki ,&nbsp;Masafumi Horie ,&nbsp;Ryo Matsunaga ,&nbsp;Hirokazu Okada ,&nbsp;Myongsu Ha ,&nbsp;Masanori Taki ,&nbsp;Kuniji Ohara ,&nbsp;Satoshi Yamaguchi","doi":"10.1016/j.jos.2025.08.004","DOIUrl":"10.1016/j.jos.2025.08.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Hallux valgus (HV) is a common foot deformity characterized by lateral deviation of the great toe. Despite known associations with gender, age, and footwear, the prevalence of HV and its associated risk factors in Japan remain unclear. We conducted the first-ever prospective population-based cohort study (HAPPI study) in Japan to elucidate the prevalence of HV and identify its associated risk factors.</div></div><div><h3>Methods</h3><div>HAPPI study is a prospective, population-based cohort conducted in Japan from 2020 to 2023. A total of 1499 participants aged 20 and older were included across seven geographic regions in this analysis. HV was objectively assessed using self-photographs, with a hallux valgus angle ≥15° defining the condition. Demographic, clinical, and footwear-related data were collected via questionnaires. Logistic regression analysis identified risk factors, calculating odds ratio (OR) and 95 % confidence interval (CI).</div></div><div><h3>Results</h3><div>The prevalence of HV was 23.5 %, with higher rates in women (31.6 %) than men (13.3 %). Age-specific prevalence rates among women increased from 20.0 % in their 20s to 48.0 % in those aged 80 years or older. Bilateral HV was observed in 12.4 % of participants (5.7 % in men, 17.7 % in women), while unilateral HV was observed in 11.1 % (7.5 % in men, 13.9 % in women). Logistic regression identified significant risk factors, including female gender (OR: 3.2, 95 % CI: 2.4–4.4) and age ≥60 years. High-heeled shoe use in the 20s (OR: 3.3, 95 % CI: 1.2–9.5) and very narrow toe-box shapes (OR: 2.5, 95 % CI: 0.98–6.5) were associated with HV.</div></div><div><h3>Conclusion</h3><div>HAPPI study demonstrated that HV is prevalent in Japan, affecting nearly one in four individuals, with significantly higher rates in women and older adults. Early footwear choices, particularly the use of high-heeled and very narrow toe-box shoes, were strongly associated with HV.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 380-386"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing severe spinal deformities associated with neurofibromatosis type 1: Surgical strategies and outcomes","authors":"Shogo Hashimoto ,&nbsp;Satoshi Suzuki ,&nbsp;Kazuki Takeda ,&nbsp;Takahito Iga ,&nbsp;Toshiki Okubo ,&nbsp;Masahiro Ozaki ,&nbsp;Osahiko Tsuji ,&nbsp;Narihito Nagoshi ,&nbsp;Morio Matsumoto ,&nbsp;Masaya Nakamura ,&nbsp;Kota Watanabe","doi":"10.1016/j.jos.2025.08.002","DOIUrl":"10.1016/j.jos.2025.08.002","url":null,"abstract":"<div><h3>Background</h3><div>Surgical strategies for spinal deformities associated with neurofibromatosis type 1(NF-1) have been still controversial due to the wide variety of pathologies, particularly, for deformities with severe dystrophic changes in pediatric patients remained challenging with high complication and reoperation rates. The purpose of this study was to validate our surgical strategies by evaluating clinical and radiographical outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively evaluated 22 cases who underwent correction surgeries for spinal deformities in our institute. The investigations included patient background, presence of dystrophic changes and paravertebral tumors, surgical procedure, number of surgeries, complications and reoperation, and radiographical parameters including Cobb angle and T1-S1 length.</div></div><div><h3>Results</h3><div>The mean age at the first surgery was 11.6 ± 5.5 years. The mean follows up period was 84.3 ± 50.2 months. Of the 22 cases, 4 cases had cervical kyphosis and 18 cases had deformity in thoracic and/or lumbar spine. Dystrophic changes of spine were observed in all 4 cases with cervical kyphosis and 15 cases with spinal deformity in thoracic and/or lumbar spine. All cases with cervical kyphosis underwent posteroanterior fusion following halo gravity traction preoperatively. The mean local kyphosis of cervical spine improved from 83.7 ± 5.9° to 16.9 ± 2.4° after surgery and 19.4 ± 2.5° at final follow up, and 2 cases required unplanned surgery due to pseudarthrosis. In cases of deformity in thoracic and/or lumbar spine, 11 cases underwent posteroanterior fusion, 4 cases underwent only posterior fusion, and 3 cases underwent conventional growing-rod, of which 4 cases underwent halo gravity traction before correction surgery. The mean Cobb angle of scoliosis in thoracic and/or lumbar spine improved from 73.2 ± 16.9° to 30.9 ± 15.8° after surgery and 29.5 ± 13.3° at final follow up, and that of T1-S1 growth increased from 338.3 ± 13.3 mm to 406.3 ± 8.9 mm at final follow up. Four cases required unplanned surgery due to pseudarthrosis (n = 2) or progression of deformity (n = 2).</div></div><div><h3>Conclusion</h3><div>The fundamental of surgical treatment for NF-1-related spinal deformity is extensive rigid spinal fusion by adequate bone grafting. Even if these surgeries are performed, in some cases additional surgery could be necessary due to progression of deformity.</div><div><strong>Level of Evidence:</strong> Level III, retrospective cohort study.</div></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"31 2","pages":"Pages 290-297"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}